FILL IN FORM USING ALL CAPS.DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD.  ENTER DATES AS MMDDYYYY.  USE WHOLE DOLLARS ONLY.

  REV-1175(CT) 03-17                                                                                                                                                          MMDDYYYY
                                                                                                                                                               SCHEDULE ARTAX YEAR
                                                                                                                                                               BEGINNING
START                                                                                                                                                             TAX YEAR
Ü CORPORATION NAME                                                                           REVENUE ID                                                    ENDING

                                                 EXPLANATION FOR FILING AMENDED
                                                                  (ENTER THE TAX FORM NUMBER)

  REMINDER: Must be filed when amending any Pennsylvania tax report, including Specialty Tax Reports.
  Please provide, in as much detail as possible, the reason(s) for filing the amended report. Include a separate schedule if additional space
  is needed. NOTE: Changesin federal taxable inco me must be reported on RCT-128C. An amended RCT-101, PA Corporate Net Income Tax
  Report, will not be accepted in these cases.

     EXPLANATION

                                              SUMMARY OF TAX CHANGE
                     TAX AS PREVIOUSLY
     TYPE OF TAX                                                  TAX AS AMENDEDCHANGE IN TAX
                     FILED OR ADJUSTED

  To pursue appeal rights, a taxpayer must timely file a petition for reassessment or a petition for refund. The filing of an amended report does not replace the
  filing of a petition for reassessment or a petition for refund. 
  Tax Preparer’s Signature                                                                                                                                    DateMMDDYYYY
                     Signature of Preparer – Please sign after printing

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